Frequent Misinterpretations Research Articles

Long-term patency of arteriovenous fistulas for hemodialysis: A decade's experience in a transplant unit.

The heterogeneous quality of studies on arteriovenous fistulas outcome, with variable clinical settings and large variations in definitions of patency and failure rates, leads to frequent misinterpretations and overestimation of arteriovenous fistula patency. Hence, this study aimed to provide realistic and clinically relevant long-term arteriovenous fistula outcomes. We retrospectively analyzed all autologous arteriovenous fistulas at our center over a 10-year period (2012-2022). Primary and secondary patency analysis was conducted using the Kaplan-Meier method; multivariate analysis of variance was used to detect outcome predictors. Vascular access-specific endpoints were defined according to the European guidelines on vascular access formation. Of 312 arteriovenous fistulas, 57.5% (n = 181) were radio-cephalic (RC_AVF), 35.2% (n = 111) brachio-cephalic (BC_AVF), and 6.3% (n = 20) brachio-basilic (BB_AVF). 6, 12, and 24 months follow-up was available in 290 (92.1%), 282 (89.5%), and 259 (82.2%) patients, respectively. Primary patency rates at 6, 12, and 24 months were 39.5%, 34.8%, and 27.2% for RC_AVF, 58.3%, 44.4%, and 27.8% for BC_AVF, and 40.0%, 42.1%, and 22.2% for BB_AVF (p = 0.15). Secondary patency rates at 6, 12, and 24 months were 65.7%, 63.8%, and 59.0% for RC_AVF, 77.7%, 72.0%, and 59.6% for BC_AVF, and 65.0%, 68.4%, and 61.1% for BB_AVF (p = 0.29). Factors associated with lower primary and secondary patency were hemodialysis at time of arteriovenous fistula formation (p = 0.037 and p = 0.024, respectively) and higher Charlson Comorbidity Index (p = 0.036 and p < 0.001, respectively). Previous kidney transplant showed inferior primary patency (p = 0.005); higher age inferior secondary patency (p < 0.001). Vascular access care remains challenging and salvage interventions are often needed to achieve maturation or maintain patency. Strict adherence to standardized outcome reporting in vascular access surgery paints a more realistic picture of arteriovenous fistula patency and enables reliable intercenter comparison.

Monitoring of Thyroid Malfunction and Therapies in Pregnancy and the Postpartum Period: A Systematic Updated Critical Review of the Literature.

From the very beginning of pregnancy, the maternal thyroid has to adapt to increased thyroid hormone secretion of up to 50%. This is paralleled by changes in thyroid-stimulating hormone secretion and by the thyroid-topic action of human chorionic gonadotropin. Thus, hypothyroidism and hyperthyroidism may occur. Many women exhibit preexisting thyroid diseases. This review tries to add the most recently published approaches to diagnosing thyroid malfunction in pregnancy to existing guidelines. Different literature-based approaches to diagnosing thyroid malfunction during pregnancy and the postpartum period were applied. To diagnose thyroid malfunction in pregnancy, trimester-specific reference ranges for thyroid-stimulating hormone and T4 are used. Definitions of thyroid malfunction are given. Treatment schedules for various thyroid diseases were reviewed and, on the basis of recent findings, were revised where necessary. For a daily clinical workup, this outline not only suggests diagnostic and therapeutic steps but also refers to frequent pitfalls and misinterpretations of laboratory data. Although the body of knowledge is increasing rapidly, the authors believe that this review is able to present new ideas concerning diagnostic and therapeutic tools for thyroid malfunction in pregnancy and the postpartum period. Nevertheless, there seems to remain room for individual approaches based on the personal experience of physicians who deal with these issues regularly.

Global citizenship education at the crossroads: Globalization, global commons, common good, and critical consciousness

This article-dialogue addresses current criticisms of global citizenship and challenges frequent misinterpretations of Global Citizenship Education (GCE), while discussing what it means to educate for critical global citizenry in an increasingly multicultural world. It starts by considering the phenomena of globalization and the UN Global Education First Initiative (GEFI), which aims at furthering global citizenship, to highlight the relationship between GCE, “global-peace”, global commons, and common good. Building on the assumption that GCE should be about learners’ emancipation toward critical consciousness, the dialogue concludes drawing a parallel between the “mission” of GCE in contemporary educational institutions and Paulo Freire’s notion of critical consciousness.

Fathers’ and Mothers’ Early Mind-Mindedness Predicts Social Competence and Behavior Problems in Childhood

Parental mind-mindedness, the parent’s propensity to treat the child as an intentional agent, has repeatedly shown to promote children’s development of social understanding and secure attachment. Less is known about whether the impact of maternal and paternal mind-mindedness extends to children’s social and behavior problems. We investigated the combined effect of mothers’ and fathers’ (N = 104) mind-mindedness at 4, 12, and 30 months on children’s social competence and externalizing and internalizing behavior problems at 4.5 years. Besides, we examined the stability, continuity, parental concordance, and inter-parental differences in the use of mind-related comments. Appropriate mind-mindedness (i.e., correct interpretations of the child’s mental states) and nonattuned mind-mindedness (i.e., misinterpretations of the child’s mental states) were observed during parent-child free-play interactions. Social competence, internalizing and externalizing behavior problems were assessed using both parents’ reports. Hierarchical multiple regression analyses showed that, at 30 months, infrequent use of appropriate mind-related comments of both parents predicted children’s externalizing problems, while their frequent use of nonattuned comments predicted children’s low social competence. Furthermore, mothers’ frequent use of nonattuned comments at 12 and 30 months and fathers’ nonattuned comments at 30 months predicted children’s externalizing behavior. The findings suggest that both parents’ low use of mind-related comments, and frequent misinterpretations of their child’s mind, may act as risk factors for later social and behavior problems of their child.

Optical coherence tomography--high-resolution tissue imaging, but not histology!

Optical coherence tomography (OCT) is a non-invasive and fast method for retinal in vivo imaging. It was introduced in 1991 and became commercially available in 1996. With higher resolution spectral domain OCT (SD-OCT), all histological retinal layers can be identified with an axial resolution of 1-5 µm today. Numerous papers have correlated OCT and histological images of physiological retina from different species. Reliable attribution of the reflective bands in OCT images to histological layers has been facilitated even for those layers that are displayed differently in OCT and histology, particularly in the outer retina. In contrast, the correlation of OCT and histology of pathologically altered human retina has only rarely been described due to very limited histological availability. The studies that presented such a correlation on animal material were able to identify some artifacts of histological processing. They also showed that OCT reflectivity changes do not necessarily correlate with cell density in the retina, such that a retinal scar, which is rich in fibres, may appear isoreflective to surrounding healthy retina. This issue, however, has mostly been neglected. Morphometric analyses revealed significantly larger diameters in OCT images compared to histology of photocoagulation lesions. Obviously, OCT reflectivity changes indicate a different tissue condition than altered HE-staining properties in histology. While coarse retinal structure alterations may be located and followed very well with OCT, it is almost impossible to derive from an OCT image the histological change that causes the alteration on a cellular level. This leads to frequent misinterpretations of OCT images. This article aims to pinpoint the pitfalls of OCT interpretation with examples from the current literature, and it encourages the reader to be attentive and critical when interpreting OCT images.

Trends in the evolution of life, brains and intelligence

AbstractThefIterm of Drake's equation – the fraction of life-bearing planets on which ‘intelligent’ life evolved – has been the subject of much debate in the last few decades. Several leading evolutionary biologists have endorsed the thesis that the probability of intelligent life elsewhere in the universe is vanishingly small. A discussion of this thesis is proposed here that focuses on a key issue in the debate: the existence of evolutionary trends, often presented as trends towards higher complexity, and their possible significance. The present state of knowledge on trends is reviewed. Measurements of quantitative variables that describe important features of the evolution of living organisms – their hierarchical organization, size and biodiversity – and of brains – their overall size, the number and size of their components – in relation to their cognitive abilities, provide reliable evidence of the reality and generality of evolutionary trends. Properties of trends are inferred and frequent misinterpretations (including an excessive stress on mere ‘complexity’) that prevent the objective assessment of trends are considered. Finally, several arguments against the repeatability of evolution to intelligence are discussed. It is concluded that no compelling argument exists for an exceedingly small probabilityfI. More research is needed before this wide-ranging negative conclusion is accepted.

How to diagnose hepatic encephalopathy in the emergency department

Introduction. Blood ammonia-measurements are often performed in the emergency departments to diagnose or rule out hepatic encephalopathy (HE). However, the utility and correct interpretation of ammonia levels is a matter of discussion. At this end the present prospective study evaluated whether blood ammonia levels coincide with HE which was also established by the West Haven criteria and the critical flicker frequency, respectively.Material and methods. In 59 patients with known cirrhosis ammonia-levels were determined and patient were additionally categorized by the West-Haven criteria and were also evaluated psychophysiologically using the critical flicker frequency, CFF for the presence of HE.Results. When false positive and false negative results were collapsed the determination of blood ammonia levels alone resulted in 40.7% in a misdiagnoses of HE compared to the West-Haven criteria (24/59 when using West-Haven criteria, 95% confidence interval [CI], 28.1% to 54.3%) and 49.2% when compared with the results of the CFF (29/59, when using CFF, 95% CI, 35.9% to 62.5%).Discussion. Ammonia blood levels do not reliably detect HE and the determination of blood ammonia can not be regarded a useful screening test for HE. Its use as sole indicator for a HE in the Emergency Department may frequently result in frequent misinterpretations.

Computation of measures of effect size for neuroscience data sets

The overwhelming majority of research in the neurosciences employs P-values stemming from tests of statistical significance to decide on the presence or absence of an effect of some treatment variable. Although a continuous variable, the P-value is commonly used to reach a dichotomous decision about the presence of an effect around an arbitrary criterion of 0.05. This analysis strategy is widely used, but has been heavily criticized in the past decades. To counter frequent misinterpretations of P-values, it has been advocated to complement or replace P-values with measures of effect size (MES). Many psychological, biological and medical journals now recommend reporting appropriate MES. One hindrance to the more frequent use of MES may be their scarcity in standard statistical software packages. Also, the arguably most widespread data analysis software in neuroscience, matlab, does not provide MES beyond correlation and receiver-operating characteristic analysis. Here we review the most common criticisms of significance testing and provide several examples from neuroscience where use of MES conveys insights not amenable through the use of P-values alone. We introduce an open-access matlab toolbox providing a wide range of MES to complement the frequently used types of hypothesis tests, such as t-tests and analysis of variance. The accompanying documentation provides calculation formulae, intuitive explanations and example calculations for each measure. The toolbox described is usable without sophisticated statistical knowledge and should be useful to neuroscientists wishing to enhance their repertoire of statistical reporting.

Heparininduzierte Thrombozytopenie

Heparin-induced thrombocytopenia (HIT) represents a serious side effect caused by an atypical immune response to platelet factor 4 leading to platelet activation and thrombin formation. These patients are at high risk of thromboembolism, with a rapid drop in platelet count between days 5 and 14 after the initiation of heparin treatment. In single cases, especially after major surgery, platelet count reduction might be absent or hidden by preceding thrombocytosis. Different clinical manifestations of HIT include unspecific skin reactions with potential necrosis at the site of heparin injection, mostly after the application of unfractionated heparin but also with low molecular weight heparin. In heparin-induced skin necrosis, administration of unfractionated or low molecular weight heparin is contraindicated and heparin therapy should be stopped immediately. Instead, an alternative anticoagulant in the form of a direct thrombin inhibitor such as argatroban, and respectively lepirudin, or danaparoid sodium must be administered. Due to frequent misinterpretations of heparin-induced unspecific skin reactions, especially in the absence of thrombocytopenia, we present two case reports which should increase the awareness of HIT's various clinical pictures.

The "incorrect" laboratory result. II: Common misinterpretations of laboratory results

In the second part of our review the most frequent misinterpretations of laboratory results in the daily clinical practise are discussed. Special attention has been given to frequent misinterpretations in the analysis of electrolytes, enzymes and hormones in plasma/serum (pseudohyperkalemia, macroenzymes, macroprolactinemia). Misinterpretations of the testing of blood gases, serum glucose, lipid concentrations, and calcium are described in greater detail. In addition, potential errors in the urinanalysis and the importance of adequate sampling of blood specimens for coagulation testing are described. The hematological results can be misinterpreted in the presence of EDTA-induced pseudothrombocytenia and of irregular immunoglobulines. Immunological methods themselves can lead to misinterpretations of the laboratory result, e. g. caused by the high dose hook effect and interferences in the presence of rheumatoid factor or HAMA. Finally clinical relevant errors in the therapeutic drug monitoring are discussed which are associated with the limited specificity of the antibodies in the commonly used immunological tests.

UPPER JURASSIC OUTCROPS ALONG THE CALDAS DA RAINHA DIAPIR, WEST CENTRAL PORTUGAL: A REGIONAL GEOHERITAGE OVERVIEW

The Mesozoic Portuguese geological heritage is very rich and varied, a legacy of the position in the western margin of Iberia and its relationship with the evolution of the North Atlantic, with an interesting tectonic history since the Late Triassic. Regarding the Upper Jurassic several connections can be established between the tectonics and the stratigraphic record in the area surrounding the Caldas da Rainha structure: the basement and salt pillow control on deposition; the beginning of a diapiric and magmatic cycle associated to the on-set of sea-floor and the exhumation of both Jurassic deposits and the core of their controlling diapirs. The nature of the outcrops and richness in sedimentary environments, related with the different phases of rifting, is a remarkable case for extensional basin studies. Geological sites can be of regional, national or international importance due to scientific, educational, economical, social or historical reasons. The present proposal can be considered as a model for the establishment of tourist/educational routes with a strong component in communication on Earth Sciences, integrating social and historical aspects at a regional level. The recognition of those sites as geoheritage may contribute to a more sustainable management, in particular because it allows the achievement of a critical dimension for the investment in human resources and marketing. In Portugal, recent legal evolution might be considered promising. Nevertheless, since implementation of the concept of protected site depends on the approval of detailed management programs, there are frequent delays, misinterpretations and disrespect of legislation. The strategy to be adopted must integrate conservation, scientific studies and science communication in projects with economic and social interest.

Les marques morpho-dynamiques de l'insulte en Langue des Signes Française

Insults belong to an intimate speech register which relates to emotional exchanges. More than any other, this speech register involves attitudes and corporal expression. The status of corporal expression is a cause of frequent misinterpretations in the analysis of French Sign Language (FSL) System, as FSL makes the body both the substance and the form of its expression (after Hjemslev 1971, following Saussure), and the situational context and enunciation marks may hardly be compared to those of oral languages. The examples quoted in this study corne from field observation, elicited syntactic constructions from sign games and the lexicon. Their analysis presented here insists on some of the defining characteristics of FSL as opposed to those found in oral languages. These characteristics comprise structural variations in the vocabulary of insults; the function of movement function in the dynamics of meaning organisation calls for a different approach with respect to grammatical catégorisation as belonging solely to oral languages (in the opposition for instance of nouns and verbs). The issue ofthe function of movement in FSL is related to that of the verb's dynamic in oral language. From a general point of view, the opposition between nouns and verbs are conveyed by movement alone; and movement is central to the communication of such a dynamic phenomenon as insults. The criteria for the identification of pragmatic distinctions in FSL are still vague as they are again borrowed from oral languages. The analysis of the enunciation marks characterising insults in FSL is bound to shed a new light on the division between pragmatic markers and purely linguistic ones. Contributing to the topology of relationships posed by insults in a three-dimensional language space, these markers are different from the oral language markers (i.e. intonation, behaviour, etc.) in that they do not use the canonical forms of the linguistic units.

Hydrothermal breccias in vein-type ore deposits: A review of mechanisms, morphology and size distribution

Breccias are among the most widely distributed rock textures found in hydrothermal vein-type deposits. Previous studies have mainly been interested in developing qualitative descriptive approaches, leading to a confusing profusion of terms. Brecciation originates in numerous ways, resulting in highly complex classification systems and frequent misinterpretations of facies. Field observations are difficult to reconcile with physical theories of fragmentation, partly due to the fact that few satisfactory quantitative tools have been developed. A review of the main brecciation processes occurring in hydrothermal vein-type deposits allows for the discrimination between chemical and physical mechanisms, including tectonic comminution, wear abrasion, two types of fluid-assisted brecciation (hydraulic and critical), volume expansion or reduction, impact and collapse. Each of these mechanisms can be distinguished using nonscalar parameters that describe breccia geometry, including fragment morphology, size distribution of the fragments, fabric, and dilation ratio. The first two parameters are especially important because: (1) the morphology of the fragments allows chemical and physical (mechanical) breccias to be distinguished, and (2) the particle size distribution (PSD) is a function of the energy input during breccia formation. The slope of the cumulative PSD (fractal dimension) ranges from high values for high-energy brecciation processes, to low values for low energy processes indicated by an isometric distribution. The evolution of a vein system can be divided into three stages: propagation, wear and dilation. These stages are separated by one threshold of mechanical discontinuity and one of hydraulic continuity. These two thresholds also mark the transition between different types of brecciation. Mineralization occurs during all three stages and may display different textures due to pressure variations. The use of quantitative parameters in fault-related hydrothermal breccias allows a better understanding of the physical parameters related to a vein environment, including structural setting and crustal level, as well as fluid–rock interactions. Recognition of the different breccia types could also be important during the early stages of mineral exploration.

Sampling in qualitative research. Purposeful and theoretical sampling; merging or clear boundaries?

Sampling is a very complex issue in qualitative research as there are many variations of qualitative sampling described in the literature and much confusion and overlapping of types of sampling, particularly in the case of purposeful and theoretical sampling. The terms purposeful and theoretical are viewed synonomously and used interchangeably in the literature. Many of the most frequent misinterpretations relate to the disparate meanings and usage of the terminology. It is important that the terminology is examined so that underlying assumptions be made more explicit. Lack of shared meanings and terminology in the nursing discourse creates confusion for the neophyte researcher and increases the production of studies with weak methodologies. This paper analyses critically purposeful and theoretical sampling and offers clarification on the use of theoretical sampling for nursing research. The aim is not to make prescriptive statements on sampling; rather, to enhance understanding of the differences between purposeful and theoretical sampling for nursing research.

A Dialogue: Culture, Language, and Race

The following is part of an ongoing dialogue that Donaldo Macedo and Paulo Freire have been having since 1983. As it attempts to address the current criticisms of Freire's work along the lines of gender and race, this dialogue not only challenges the frequent misinterpretations of his leading philosophical ideas by conservative and some liberal educators, but will also embrace contemporary educational issues and discuss what it means to educate for critical citizenry in the ever-increasing multiracial and multicultural world of the twenty-first century.

The Reluctance to Change a Way of Thinking

The theory of Radical Constructivism is restated with emphasis on its two basic principles: 1) that knowledge is built up through subjective activity, and 2) that the function of cognition is adaptive and focused on the organisation of the experiential world. The work of Piaget is used both to illuminate an innovation in constructivistic theory that was misinterpreted, and to provide a language for analysing such misinterpretations. The most frequent misinterpretations and objections to Radical Constructivism are outlined and refuted. These include the issues of solipsism, instrumentation, the relativity of problems and solutions, and the constructivist analysis of language and communication.

The concept of the photon

The idea of the photon has stirred the imaginations of physicists ever since 1905 when Einstein originally proposed the use of light quanta to explain the photoelectric effect. This concept is formalized in the quantum theory of radiation, which has had unfailing success in explaining the interaction of electromagnetic radiation with matter, seemingly limited only by the ability of physicists to perform the indicated calculations. Nevertheless, it has its conceptual problems—various infinities and frequent misinterpretations. Consequently an increasing number of workers are asking, “to what extent is the quantized field really necessary and useful?” In fact the experimental results of the photoelectric effect were explained by G. Wentzel in 1927 without the quantum theory of radiation. Similarly most electro-optic phenomena such as stimulated emission, reaction of the emitted field on the emitting atom, resonance fluorescence, and so on, do not require the quantization of the field for their explanation. As we will see, these processes can all be quantitatively explained and physically understood in terms of the semiclassical theory of the matter–field interaction in which the electric field is treated classically while the atoms obey the laws of quantum mechanics. The quantized field is fundamentally required for accurate descriptions of certain processes involving fluctuations in the electromagnetic field: for example, spontaneous emission, the Lamb shift, the anomalous magnetic moment of the electron, and certain aspects of blackbody radiation. (The Compton effect also fits here, but see later under references 8b and c.) Here we will outline how the photon concept originated and developed, where it is not required and is often misused, and finally where it plays an essential role in the understanding of physical phenomena. In our discussion we will attempt to give a logically consistent definition of the word “photon”—a statement far more necessary than one might think, for so many contradictory uses exist of this elusive beast. In particular consider the original coining of the word by G. N. Lewis: “[because it appears to spend] only a minute fraction of its existence as a carrier of radiant energy, while the rest of the time it remains an important structural element within the atom…, I therefore take the liberty of proposing for this hypothetical new atom which is not light but plays an essential part in every process of radiation, the name photon!” (our exclamation point). Clearly the present usage of the word is very different.

Idolatrada, pero incomprendida. El significado del valor de p.

El valor de p indica la probabilidad de obtener un valor tan o más extremo al observado, partiendo de la suposición de la igualdad de efecto que marca la hipótesis nula. Sin embargo, es frecuente malinterpretar este valor, dándose interpretaciones al valor de p que poco tienen que ver con su significado real. Se explica el significado del valor de p y algunas de sus malinterpretaciones más frecuentes. ABSTRACT Worshipped, but misunderstood. The meaning of the value of p. The value of p indicates the probability of obtaining a value as extreme or more than that observed, based on the assumption of the equality of effect that marks the null hypothesis. However, it is common to misunderstand this value, giving interpretations to the value of p that have little to do with its real meaning. We review the meaning of the value of p and some of its most frequent misinterpretations.

The caudal fin of fishes (preliminary paper)

The aim of the present paper is to give, as concisely as possible, the summary of two years' work on the caudal fins of fishes and also to revise the definitions relating to the different types of caudal fin. The revision of the definitions of old established names such as protocercy, heterocercy, etc., has proved to be quite essential owing to the vagueness and even errors connected with these terms so much in evidence in text-books of zoology; this vagueness undoubtedly exists, or otherwise such mistakes as attributing diphycercy to such types as the Gadidæ and the eels would not occur as they do. I have also been assured by several eminent teachers of zoology that the subject needs clearing up. The whole of my work has included the examination of well over a hundred different species of fishes representative of nearly all the sub-groups of Teleosts, several Ganoids, and a few Elasmobranchs. Probably the most interesting results have been obtained from the Gadidæ and Apodes and the frequent misinterpretations to be read on the caudal fin of these groups has convinced me that caudal fins have not been subjected to a sufficiently close structural examination; for this reason I have made a point of examining microscopically every tail fin, and have invariably subjected each one to clearing agents, a process which has revealed many features it is impossible to recognise by mere dissection.